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Learning to speak again

Losing your voice is likely to be a shock if you have had your larynx completely removed (a total laryngectomy).

During the operation, your surgeon separates your windpipe (trachea) from your mouth and food pipe. You have a hole in your neck, called a stoma, that you breathe through.

With a breathing stoma, you can no longer force air from your lungs through your mouth to speak. So you have to learn new ways of communicating. 

Before your surgery

You see a speech and language therapist before your operation to discuss the different ways you can communicate after your surgery. You might also be able to meet someone who has had a similar surgery or see videos of people communicating after their laryngectomy.

Types of communication

The type of communication you can use will depend on your individual situation, the type and amount of surgery you have and what you prefer. There are 3 main ways to help you make sounds and learn to speak again. These are:

  • voice prosthesis or tracheo oesophageal puncture (TEP)
  • oesophageal speech or swallowing air
  • electrolarynx

The main aim is to keep your life as normal as possible. This means helping you to feel confident speaking with people in everyday situations, including using the telephone. Some options are likely to be better suited to your work and home situation than others.

Voice prosthesis (tracheo oesophageal puncture or TEP)

This is the most common way to restore speech after a total laryngectomy. But it isn't suitable for everyone.

Your surgeon makes an opening between your windpipe and food pipe (oesophagus) and puts a small valve into it. This allows you to make sounds.

Oesophageal speech

You create speech by moving air down into the food pipe (oesophagus) and then back up into your mouth. You don't need any equipment with this way of communicating. 


An electrolarynx (electronic larynx) is a battery operated machine that produces sound for you. They are usually about the size of a small electric razor. You hold the machine against your neck, or fit a small tube into the corner of your mouth. 

Writing things down

You might find it useful to carry a small notebook and pen so that you can write notes to people if you need to. Laptop computers, smartphones, tablets, electronic notebooks or keyboards are other ways you can communicate.

A number of small portable machines are available. Your speech and language therapist can advise you on which might suit you best.

You can also speak to someone who uses the same type of communication that you have chosen. The National Association of Laryngectomee Clubs (NALC) is an organisation that offers support before and after surgery to remove the larynx.

Last reviewed: 
30 Jul 2018
  • The Royal Marsden Manual of Clinical Nursing Procedures

    L. Dougherty and S. Lister, 9th edition, 2015

  • Prosthetic Surgical Voice Restoration (SVR): The role of the speech and language therapist

    Royal College of Speech and Language Therapists, 2010.